Pediatric telemedicine services can work well under the right conditions

August 6, 2018, Springer

Doctors who provide pediatric care over the telephone—known as "telemedicine—face a range of challenges that do not come with traditional face-to-face contact. In a qualitative study led by Motti Haimi of Clalit Health Services at the Children's Health Center in Haifa in Israel, researchers found that physicians in a pediatric telemedicine service frequently face difficulties and challenges. Physicians described the difficulties with diagnosing from a distance (especially of children), treating unfamiliar patients, working alone, and managing the urgency and volume of calls. They also often faced technological hurdles, as well as a moral conflict between the desire to meet parents' expectations and maintain standards of care. The research is published in the Springer Nature journal Pediatric Research.

Telephone consultations allow patients to have contact with healthcare professionals remotely so that there is no need for travel. This type of telemedicine allows doctors to assess how urgently a patient needs help and make recommendations for treatment. Researchers estimate that up to 25 per cent of doctor-patient encounters occur through telemedicine.

Telemedicine is considered a high-stress clinical activity because doctors often need to make urgent decisions in uncertain circumstances. Haimi and his colleagues wanted to investigate the experiences and attitudes of physicians working in this service and gauge whether non-medical factors also play a role in clinical decisions in this setting.

Haimi and his colleagues interviewed 15 randomly selected pediatricians who work for a pediatric telemedicine service in Israel. The service provides remote consultation for parents who need urgent medical advice about their children out of community clinic hours. Doctors working for this service conduct an initial telephone conversation with parents, but can additionally use live video chat via computers or mobile devices. They also have access to the medical records of the child.

Analysis of the interview results showed that there were six main areas that presented challenges for pediatricians. Almost all physicians said that they were worried about making a misdiagnosis or failing to assess the severity of a patient's illness because they were not physically able to examine the child. Other concerns included the fact that the doctors work at home alone and are unable to share thoughts with colleagues. The urgency and load of calls also put some of the doctors under pressure.

"To overcome the problems mentioned above, the physicians in this study used different strategies, including use of intuition, their experience, and taking protocols. They confessed that they used non-medical or contextual factors to make decisions in this high-stress environment," explains Haimi. The physicians also suggested practical tips and concrete ways in which the telemedicine process could be improved.

"It is clear that working in this pediatric service should have special qualities and skills beyond those required from standard physicians," says Haimi. "Decision-makers should be aware of the challenges and special skills and training required to succeed in this setting."

Explore further: Telemedicine cuts inter-hospital ICU transfers of critically ill

More information: Motti Haimi et al, Physicians' experiences, attitudes and challenges in a Pediatric Telemedicine Service, Pediatric Research (2018). DOI: 10.1038/s41390-018-0117-6

Related Stories

Telemedicine cuts inter-hospital ICU transfers of critically ill

August 1, 2018
(HealthDay)—Telemedicine is associated with a decrease in inter-hospital intensive care unit (ICU) transfers, according to a study published in the July issue of Chest.

Issues to consider with integration of telemedicine

August 10, 2014
(HealthDay)—Integrating telemedicine raises various considerations, including operational and legal issues, according to an article published July 24 in Medical Economics.

Telemedicine consultations significantly improve pediatric care in rural emergency rooms

August 8, 2013
Telemedicine consultations with pediatric critical-care medicine physicians significantly improve the quality of care for seriously ill and injured children treated in remote rural emergency rooms, where pediatricians and ...

ACP supports expanded role of telemedicine for health care

September 9, 2015
(HealthDay)—Telemedicine can be beneficial, within the framework of an established physician-patient relationship, according to a position paper published online Sept. 8 in the Annals of Internal Medicine.

Telemedicine facilitates diabetes foot ulcer care

December 14, 2017
(HealthDay)—Telemedicine follow-up enables more comprehensive diabetes foot ulcer care, according to a study published online Nov. 29 in the Journal of Clinical Nursing.

Telemedicine in rural ER tied to fewer physician Rx errors

November 27, 2013
(HealthDay)—For seriously ill and injured children, the use of telemedicine consultations in rural emergency departments is associated with fewer physician-related medication errors, according to a study published online ...

Recommended for you

Siblings of children with autism or ADHD are at elevated risk for both disorders

December 10, 2018
Later-born siblings of children with autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) are at elevated risk for both disorders, a new study led by Meghan Miller, assistant professor in the ...

RSV study reveals age when infants are most vulnerable to asthma

December 5, 2018
New research suggests a maternal vaccination against RSV should be augmented with active immunisation in a child's first two years to reduce the onset of asthma.

The powerful impact of real-world learning experiences for kids

December 4, 2018
Real-world learning experiences, like summer camps, can significantly improve children's knowledge in a matter of just days, a new study suggests.

Mediterranean diet during pregnancy associated with lower risk of accelerated growth

December 4, 2018
The Mediterranean diet is characterised by a high content of fruits, vegetables, olive oil, legumes and nuts. This healthy diet pattern has been associated with lower obesity and cardiometabolic risk in adults, but few studies ...

Global review reports on administration of children's antibiotics

December 4, 2018
Researchers analyzing the sales of oral antibiotics for children in 70 high- and middle-income countries found that consumption varies widely from country to country with little correlation between countries' wealth and the ...

New review highlights importance of good sleep routines for children

December 3, 2018
Sleep hygiene, which includes practices like providing a cool and quiet sleeping environment or reading before bed time to help kids unwind, is increasingly popular among parents looking to ensure their children get a good ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.